Abstract
Objective To describe the technique of endoscopic-assisted ulnar nerve decompression and subcutaneous anterior transposition within one incision using carbon dioxide inflation.Methods From 2005 to 2008,8 male and4 female patients with an average age of 42 years (rare,25 to56 years) who presented signs,symptoms and abnormal neurophysiological studies of cubital tunnel syndrome (CuTS) were recruited in the study.They were operated on using a 0° lens endoscope.A single longitudinal small incision was made at the medial side of the elbow.CO2 was pumped between the subcutaneous layer and deep fascia to create a cavity for ulnar nerve neurolysis and anterior transposition.Preoperatively,the cases were classified according to the Dellon scale,and the Bishop rating system was used to evaluate the postoperative outcomes.Results Preoperatively,5 patients were rated as mild CuTS,another 5 as moderate CuTS,and the rest 2 as severe CuTS.The average length of the incision was ( 15 + 3) mm.The mean length of endoscopically released ulnar nerve was (18 + 2) cm.The endoscopic assisted cubital tunnel release under carbon dioxide inflation and subcutaneous anterior transposition surgeries in all patients were performed with no difficulty.The entire procedure lasted (30 ± 5) minutes.All the patients had improvement of symptoms.There were no complications.Postoperative follow-up ranged from 12 to 18 months.Ten of 12 patients (83.3％) scored excellent and 2 patients (16.7％)scored good based on the modified Bishop rating system.Conclusion Endoscope-assisted cubital tunnel release and anterior transposition under carbon dioxide inflation demonstrated similar results compared to conventional open surgeries.Besides,it may avoid problems such as long incision,painful scarring and have additional advantages of providing an extended endoscopic view,which is safe and minimally invasive. Key words: Cubital tunnel syndrome; Endoscopes; Ulnar nerve; Anterior transposition
Published Version
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